Behavioral Economics, Health Insurance
Conditions
Keywords
Health Insurance, ACA marketplace, Behavioral Economics, Nudge
Brief summary
In May 2023, Covered California, California's ACA marketplace, implemented its automatic enrollment program for individuals losing Medicaid coverage, as defined by Senate Bill 260. If individuals are found eligible for subsidized marketplace coverage, individuals will be automatically enrolled in the lowest cost silver plan available to them, but individuals must still take action to confirm their plan or pay their first month's premium. To identify whether the phone outreach is the effective outreach strategy to increase take-up in this population, Covered California implemented this intervention. The results of this evaluation will inform operational and budgeting decisions.
Interventions
BEHAVIORALPhone Outreach
Phone outreach to individuals losing Medicaid and auto-enrolled into Covered California plan to nudge them to act
BEHAVIORALStandard Notice
Standard notification letter without phone outreach to individuals losing Medicaid and auto-enrolled into Covered California plan to nudge them to act
Sponsors
Covered California
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Lost Medi-Cal (California's Medicaid coverage) in July 2023-June 2024 * Auto-enrolled into lowest cost silver plan with Covered California as per Senate Bill 260 and have not opted-in (effectuated) into the coverage * Have a valid phone number on the health insurance application * Do not have a delegated agent to their case * Still have Covered California Program eligibility, not reverted back to Medi-Cal coverage * Have English or Spanish as preferred speaking language
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Health Plan Effectuation | within 30 days from the start date of plan they are auto-enrolled into | A binary indicator for whether a consumer is effectuated into (paid for, opt-in into) Covered California plan, either the plan assigned through the auto-enrollment process, or into another plan chosen by the consumer by the end of the month at which outreach was conducted |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Office visit | measured 1-2 years after the intervention | A binary indicator for whether someone had an office visit during 1-2 years since the intervention |
| Prescriptions filled | measured 1-2 years after the intervention | A binary indicator for whether someone had a prescription drug fill during 1-2 years since the intervention |
| Emergency Room Visit | measured 1-2 years after the intervention | A binary indicator for whether someone had an emergency room visit during 1-2 years since the intervention |
| Tenure with Covered California (measured in months) | measured 1-2 years after the intervention | A length of tenure with Covered California plan within calendar year and/or beyond |
| Out-of-pocket spending on healthcare services | measured 1-2 years after the intervention | Total out-of-pocket spending for the 1-2 years since the intervention |
| Uninsured | measured 1-2 years after the intervention | A binary indicator for whether someone self-reported being uninsured while filing their taxes |
| Hospital admission | 1-2 years before and after the intervention | A binary indicator for whether someone had a hospital admission 1-2 years before and 1-2 years after the intervention |
Countries
United States
Outcome results
None listed